Dietitians Australia has submitted its response to the National Disability Insurance Agency's (NDIA) Annual Pricing Review for 2027–28, calling for urgent action to protect the viability of dietetic services and participant access to Accredited Practising Dietitians (APDs).

Our key recommendation is to restore the dietitian hourly price limit, introduce annual indexation and prevent further reductions while the Therapy Pricing Review is underway.

Importantly, DA is calling for the NDIA to work with us to develop a transparent, evidence-based, profession-specific dietetic cost model that reflects the actual cost of delivering safe, high-quality disability-related nutrition care.

Our submission draws on member experiences, critical case studies, NDIA payment data, the academic and grey literature, DA survey data, and independent sustainable pricing research commissioned from Nous Group.

The evidence raises significant concerns:

• The number of participants receiving support under the main dietitian therapy item fell by approximately 10% in the year to June 2026.
• Dietetic service use declined across 66 of 76 NDIS service districts analysed, showing clearly reduced dietetic services in rural areas.
• Nous modelling indicates sustainable hourly rates of $191–$209 for experienced dietitians at 70% utilisation, based on mid-range cost assumptions. Given the NDIA’s use of the 75th percentile when benchmarking Medicare and private health insurance fees, these estimates should be regarded as a conservative minimum, particularly considering the greater clinical complexity, coordination requirements and service delivery costs associated with disability-related dietetic care.
• Current pricing does not adequately reflect essential clinical preparation, documentation, coordination, supervision, administration and business costs.

Our proposed cost model would account for five key components: experienced APD salaries, employment on-costs, realistic billable utilisation, operational and corporate overheads, and a reasonable commercial margin.

We are also calling for:

• Address historical gender-based undervaluation: Ensure NDIS dietetic pricing reflects the Fair Work Commission’s findings on gender-based undervaluation of health professionals, including the wage increases commencing 1 October 2026. Pricing must recognise the qualifications, expertise and responsibilities of APDs in this predominantly (95%) female profession.
• Urgently expand the Therapy Pricing Pilot: Include sole practitioners and small and medium-sized dietetic businesses, which form about 80% of our workforce, alongside larger registered providers to ensure pricing decisions reflect the actual costs of delivering safe, high-quality dietetic care across different practice settings and business models
• Fair travel payments, recognition of award wage increases, sufficient funded dietetic hours and meaningful inclusion of sole practitioners and small businesses in pricing research.

Thank you to the APDs who contributed evidence and experiences. Your input strengthens our advocacy for fair pricing, a sustainable dietetic workforce and continued access to quality nutrition care for people with disability.